November 23 coronavirus news

By Jessie Yeung, Adam Renton, Emma Reynolds, Ed Upright, Melissa Macaya and Mike Hayes, CNN

Updated 12:01 a.m. ET, November 24, 2020
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12:59 p.m. ET, November 23, 2020

Oklahoma reports more than 3,000 new Covid-19 cases for the third day in a row 

From CNN's Kay Jones

Oklahoma reported Monday more than 3,500 new Covid-19 cases. It is the third day in a row the state has reported more than 3,000 new cases. 

There are now 177,874 total cases in the state, up 3,544 since the last report. The Oklahoma State Department of Health also reported 15 new deaths, bringing the total to 1,649.

The state's dashboard shows that only 5% of the state's intensive care unit beds are available. There are currently 1,495 patients hospitalized with the virus.

Note: These numbers were released by the state's public health agency and may not line up exactly in real time with CNN’s database drawn from Johns Hopkins University and the Covid Tracking Project.   

12:35 p.m. ET, November 23, 2020

Pennsylvania could run out of ICU beds "within a week," top state health official says

From CNN's Kristina Sgueglia

Pennsylvania’s top health official says latest models show the state “could run out of ICU beds within a week,” according to a news release.

Newly reported data shows hospitalizations increasing, an increase in the use of ventilators, and a percent positivity which Secretary of Health Dr. Rachel Levine calls “worrisome.”

Pennsylvania reported a seven day case increase of over 36,000 cases and a statewide positivity of 11.1%, according to the release.

That data, as of Nov. 19, shows an increase of 8,807 more new cases across the state over the past week compared to the previous week.

The statewide positivity jumped from 9.6% to 11.1%.

12:42 p.m. ET, November 23, 2020

AstraZeneca vaccine comes with advantage of easier storage, WHO chief scientist says

From CNN's Jacqueline Howard

A volunteer receives an injection at the Chris Hani Baragwanath hospital in Soweto, Johannesburg, on June 24 as part of Africa's first participation in a COVID-19 vaccine trial developed at the University of Oxford in Britain in conjunction with the pharmaceutical company AstraZeneca.
A volunteer receives an injection at the Chris Hani Baragwanath hospital in Soweto, Johannesburg, on June 24 as part of Africa's first participation in a COVID-19 vaccine trial developed at the University of Oxford in Britain in conjunction with the pharmaceutical company AstraZeneca. Siphiwe Sibeko/Pool/AP

AstraZeneca's coronavirus vaccine candidate comes with the advantage of requiring refrigeration at temperatures that are easier to reach, compared with some other vaccine candidates, a World Health Organization official pointed out during a news briefing on Monday.

WHO Chief Scientist Dr. Soumya Swaminathan said that the vaccine can be stored and is stable in temperatures of 2 to 8 degrees Celsius. In comparison, Pfizer's vaccine needs to be stored at about minus 75 degrees Celsius.

Regarding AstraZeneca's Covid-19 vaccine candidate, "The advantage of this vaccine is that it can be stored in the ordinary refrigerated temperatures," Swaminathan said.

"That of course has huge logistical advantages for transporting and delivering this vaccine to cities and towns and villages and rural areas around the world. And we hope there will be more vaccines like that, which are more heat stable," Swaminathan said.

"We have to also continue to encourage all the other developers who are doing clinical trials and were in early phases of development, because we do need a variety of vaccines out there that will target different groups that will have different storage conditions," Swaminathan said. "The issue of affordability is also important to keep in mind."

12:36 p.m. ET, November 23, 2020

Texas governor announces Covid-19 vaccine allocation process

From CNN's Kay Jones and Artmeis Moshtaghian

Texas Governor Greg Abbott speaks at a press conference at the Texas State Capitol in Austin on May 18.
Texas Governor Greg Abbott speaks at a press conference at the Texas State Capitol in Austin on May 18. Lynda M. Gonzalez/Pool/Getty Images

Texas Gov. Greg Abbott announced the state's Covid-19 vaccine allocation process today.

In a statement released by his office, Abbott and the Texas Department of State Health Services (DSHS) said that the process will serve as a foundation for the initial distribution of Covid-19 vaccines throughout the state. 

Allocations will be based on criteria that includes protecting health care workers, frontline workers and vulnerable populations, according to the release. Criteria for the vaccine also include mitigation of health inequalities and geographic diversity.

The recommendations by the Expert Vaccine Allocation Panel (EVAP) and approved by the DSHS Commissioner of Health will give health care workers and other vulnerable residents the first round of the vaccine.

Recommendations will also be made by the EVAP on when and how to roll out the vaccine to other groups. 

"These guiding principles established by the Expert Vaccine Allocation Panel will ensure that the State of Texas swiftly distributes the COVID-19 vaccine to Texans who voluntarily choose to be immunized," Abbott said in the release.

"This foundation for the allocation process will help us mitigate the spread of COVID-19 in our communities, protect the most vulnerable Texans, and safeguard crucial state resources," he continued.

12:18 p.m. ET, November 23, 2020

Here's how Florida plans to distribute a Covid-19 vaccine 

From CNN’s Denise Royale and Rosa Flores

Although a coronavirus vaccine is not yet approved, states are beginning to outline their plans for distributing the shots among key sectors of their population.

Florida posted a “draft” Covid-19 Vaccination Plan on its Department of Health website likely updated last week. The 50-page document says the state is planning to use a “time-phased” strategy that prioritizes health care personnel, essential workers, people with medical conditions that place them at higher risk of complications, and people over age 65. 

According to the draft document, Florida is waiting on additional guidance and materials from the US Centers for Disease Control and Prevention regarding Covid-19 specific training materials.

Here is a look at what the phased strategy would look like:

  • Phase 1: There would be a limited supply of the vaccine in this phase and it would require prioritizing its administration, according to the document. During this phase, the vaccine would be administered to health care workers, long-term care staff and residents, as well as first responders.  
  • Phase 2: A large number of doses would be available during this phase. At that time, vaccination will be expanded to state-managed vaccination sites, routine health care delivery settings for children, hospital in-patients and outpatients, and community-based based vaccination sites.
  • The third and final phase: During this phase, the vaccine would be widely available. Demand for the vaccine is expected to stabilize, and the state will transition to provide the vaccine through routine health care delivery systems and commercial pharmacies. Pharmacies will be queried about their storage and refrigeration capabilities.

The document warns that prioritization of vaccine recipients has not been finalized by the CDC, and priority groups may vary based on the vaccine that is ultimately approved.

The vaccination plan comes as the number of reported Covid-19 cases per week in the state has tripled since Gov. Ron DeSantis reopened Florida in late September.

In a video address last week, DeSantis announced the state purchased millions of needles, syringes and alcohol swaps to prepare for the distribution of a vaccine.

The state has identified five hospital systems across the state that can store vaccines at extreme cold temperatures.

CNN reached out to the Florida Department of Health regarding the “draft” vaccination plan and has not heard back.

11:51 a.m. ET, November 23, 2020

Where things stand in the race for a Covid-19 vaccine 

From CNN's Health team

Pfizer Covid-19 vaccine vials.
Pfizer Covid-19 vaccine vials. Pfizer

Drugmaker AstraZeneca announced on Monday that its experimental coronavirus vaccine has shown an average efficacy of 70% in large-scale trials  — the latest of several vaccine trials worldwide to post their results this month.

The news follows Pfizer and BioNTech announcement Friday that they submitted to the US Food and Drug Administration for emergency use authorization for their coronavirus vaccine candidate. The agency could make a decision early next month about whether to issue an emergency use authorization, according to a source.

Here's a look at the major developments announced by Covid-19 vaccine makers:

Pfizer 

  • Nov. 20: Pfizer submitted their application for emergency use authorization to the Food and Drug Administration.
  • Pfizer announced last week that its vaccine has a 95% efficacy rate. They included more data than they have before – looking at 170 confirmed cases of Covid-19, and they said it has 94% efficacy for people 65+.  
  • Dec. 10: The FDA advisory committee will meet to discuss Pfizer’s EUA application. 
  • If given a green light, the CDC's vaccine advisory committee will meet within 24-48 hours and make a recommendation on who should be first to get the vaccine. Shots in arms are expected to begin after that recommendation is made, likely on determination of priority.   
  • Based on current projections, Pfizer expects to produce up to 50 million vaccine doses in 2020, and up to 1.3 billion doses in 2021. They have not said how much of that would be for the US.  
  • Pfizer said last week it would test distribution of its coronavirus vaccine candidate in four states to see how hard it will be to deal with a product that has to be kept at temperatures well below the capacity of standard freezers.  

   Moderna

  • Nov. 17: Moderna announced efficacy results from a data safety monitoring board (DSMB). Initial results show 94.5% efficacy, with no significant side effects.  
  • FDA and CDC will make their determinations and recommendations, similar to the process outlined above for Pfizer.  
  • Moderna expects to have 20 million doses ready for the US by the end of the year.  
  • Same timeline as outlined by Dr. Anthony Fauci for Pfizer.  

AstraZeneca  

  • Nov. 23: AstraZeneca announced their vaccine candidate has shown an average efficacy of 70%.
  • This week: The company will show data to the FDA and regulators in Europe.  

Johnson & Johnson  

  • Nov. 19: Johnson & Johnson announced they expect efficacy results by January or February of 2021. 
  • The trial expects to reach its enrollment goal of 60,000 participants by the end of the year. 

Novavax  

  • Nov. 9: The vaccine maker announced last week it received fast-track designation from the FDA for its vaccine candidate.  
  • Novavax expects to begin its Phase 3 trial in the US and Mexico by the end of November. The vaccine candidate will require two doses with hopes to deliver 100 million units by the end of the year.  

Medicago-GSK  

  • Nov. 12: Biopharmaceutical company Medicago and GlaxoSmithKline announced that Phase 2/3 clinical trials are set to begin for a Covid-19 vaccine candidate.  
  • The trial evaluates the efficacy, safety and immunogenicity of Medicago's experimental vaccine combined with GlaxoSmithKline's booster.  
  • The Phase 3 part of the study will start before the end of this year and will evaluate the efficacy and safety of the vaccine candidate compared to a placebo in more than 30,000 subjects across North America, Latin America and/or Europe and within the same population – or a broader one pending approval by regulatory authorities.  
11:54 a.m. ET, November 23, 2020

Atlanta airport expecting one-third fewer holiday passengers than 2019

From CNN’s Kevin Conlon

A person walks through an arrival lobby at Hartsfield-Jackson International Airport on November 16 in Atlanta.
A person walks through an arrival lobby at Hartsfield-Jackson International Airport on November 16 in Atlanta. Charlie Riedel/AP

Hartsfield-Jackson Atlanta International Airport – the world’s busiest – is expecting 1.1 million passengers around the Thanksgiving holiday, down 1/3 from Thanksgiving last year, airport officials said Monday.  

The airport's general manager John Selden said the busiest day of the period – which begins today and goes through the weekend — will be Sunday, where some 190,000 passengers are expected to pass through the airport. 

Selden also debuted a revamped South Terminal TSA checkpoint that will employ three dimensional CT scanners, which he says will create greater efficiency by reducing the amount of bag searches.  

11:50 a.m. ET, November 23, 2020

NYC's top health official says "small social gatherings" are a major source of Covid-19

New York City Health Commissioner Dave Chokshi speaks during a press briefing on November 23.
New York City Health Commissioner Dave Chokshi speaks during a press briefing on November 23. NYC Media

New York City Health Commissioner Dave Chokshi issued caution ahead of the Thanksgiving holiday, warning a major source of Covid-19 spread in the city – and the country – is from small social gatherings.

"A major source is smaller social gatherings, as we head into the holidays knowing that people from different households may be gathering, may be convening, it is so important to stay safe," Chokshi said. 

"Avoid those types of smaller social gatherings if at all possible and if you do have to have them make sure you are following the rules around distancing and wearing masks because those have been major contributors to spread," he added.

Earlier Mayor Bill de Blasio echoed Chokshi's guidance, saying "please don’t travel," but if you do, "take every conceivable precaution."

11:46 a.m. ET, November 23, 2020

"Many Americans could take one simple step to protect themselves: Buy a better mask," former FDA commissioner says

From CNN Health’s Naomi Thomas

Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration, testifies during a Senate Health, Education, Labor and Pensions Committee hearing on April 5, 2017, on Capitol Hill in Washington, D.C.
Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration, testifies during a Senate Health, Education, Labor and Pensions Committee hearing on April 5, 2017, on Capitol Hill in Washington, D.C. Zach Gibson/Getty Images

Amid a rush of Thanksgiving travel, accelerating infection rates and no significant change in mobility data, "many Americans could take one simple step to protect themselves: Buy a better mask," Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration, wrote in a Wall Street Journal op-ed on Sunday.

"While there are still some shortages of medical masks, health-care workers have dedicated supply chains," Gottlieb wrote. "It’s time to revise the guidance to consumers."

N95 masks and their equivalents offer the best protection against the novel coronavirus, Gottlieb said. If used properly, they can filter out at least 95% of infectious particles. Equivalents include the KN95 from China and the FFP2 from Europe.

Surgical masks are the next best option, which could offer protection of about 60%, Gottlieb said – but quality matters. Many masks sold on Amazon say they are for dust and allergens but aren’t surgical masks. Real medical-procedure masks are cleared by the FDA and offer one of three levels of protection, with a level 2 or level 3 mask generally being best.

Finally, cloth masks are the least protective, Gottlieb said. If it is the only available option, it should be thick, snug-fitting and made of cotton-polyester blends, as these will generally offer more protection.

"But even a very good cloth mask may only be about 30% protective; scarf or bandanna, 10% or less," Gottlieb wrote.

While it may be more expensive to buy better quality masks, having a few available for high-risk settings can reduce transmission risks, he said. The Department of Homeland Security has also published online instructions for disinfecting and reusing N95 masks, which can extend their life.

"Slowing the current cycle of spread will be difficult," Gottlieb wrote. "But encouraging Americans to wear higher-quality masks is a simple step that might make a difference."